Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

Here’s the thing. Many people, when you mention a problem, feel obliged to help you fix it or fix it for you. When the problem is related to mental illness, though, that can be counterproductive.

The fact is, most serious mental illness can’t be fixed, at least not by a friend or loved one. To try is to invite frustration on the part of the fixer and worse feelings on the part of the fixee.

Some of the worst help we are offered are pep talks, which are meant to be encouraging. Smile more. Keep trying. Other people have it worse. Everyone goes through this.

No, says my stubbornly glitchy brain. Everyone does not go through a major depressive episode. And when I’m having one is not the time I can concentrate on what constitutes “worse.” I can try all I want, but my bipolar disorder isn’t going to just go away. And smiling when I’m ready to cry is a suggestion that denies my perception of reality and encourages me to lie about my feelings.

You can see much of this kind of advice on Facebook, for example. There are always memes that exhort you to look on the sunny side, have a positive mental attitude, or choose to be happy. But it’s easy enough to scroll by them.

These pep talks hurt more when they’re offered in person by someone you know or even love, especially when that person knows you have a mental disorder. You can’t just scroll by someone you love telling you that, in effect, it’s your own fault that you don’t get better.

I know these sentiments are kindly meant (except for the ones that blame you for your own condition). But the reality is that we can’t cure ourselves of SMI by smiling, or jogging, or thinking happy thoughts, or eating turmeric. We can’t cure ourselves at all.

But we can make things better, through therapy and medication, and yes, through some things that are not cures themselves but adjuncts to healing – physical activity, engagement, mindfulness, self-care, and the like. Who knows? Maybe even turmeric.

So, if pep talks don’t work, what can you do instead? What might actually help your friend or loved one? Here are a few suggestions.

Treat the person with mental illness the way you would treat a person with any other illness. I’m not suggesting sympathy cards are appropriate, but a phone call or text message saying you care is usually welcome.

Listen without judgment. Don’t offer advice. If the person opens up to you, respect that. Don’t minimize the problems. If the person doesn’t respond, wait a while and try again.

None of that will “fix” the person, but you know what? Neither will a pep talk. My brain, for one, is simply unable to process them, digs in its metaphoric heels, and says, “Oh, yeah?”

So, what are some things you can say instead of giving a pep talk? Try these.

I’m here for you.

You can always call me.

I’m sorry you’re hurting.

Tell me if you need anything.

Do you need distraction?

Do you need to be alone for a while?

Do you need to talk?

What can I do for you? (The answer may be, “nothing,” but at least you cared enough to ask.)

If you are also suffering from SMI, there is even more you can do. You can say, “I understand how you feel,” and mean it. You can recommend a therapist. You can congratulate the person on any accomplishment, the kind that wouldn’t seem like an accomplishment to anyone else.

In general, stay away from platitudes, feel-good sentiments, and quick fixes – unless you know that the person responds well to that kind of encouragement. They’re too easy to say and too hard to follow through on. Save them for people who are simply having a bad day, not someone who has mental illness.

I don’t know if I’ll be able to make a blog post next week unless I can write an extra one this week and save it. Next week at this time we’ll be moving from the three-bedroom house we’re currently living in to a one-bedroom apartment, where we expect to stay for three months at the maximum.

The circumstances that led to this situation are complex and the whole process has been feeding into my triggers and issues. No, bipolar disorder won’t stay on hold for even two weeks so we can get this accomplished.

Overthinking. First and perhaps foremost, I hate cleaning, packing, and moving, especially when there’s a time limit on them. I even hate packing for vacations. (I’m okay once the vacation has started. It’s just the lead-up to it that gets me.) When I pack, I always overthink and almost always overpack, as if I’m planning for the Normandy invasion. This is exhausting.

Anxiety. I often have anxiety dreams about packing and moving, usually having to do with moving into or out of a dorm at college. This was indeed a stressor for me, as I lived someplace different every year and went home over the summer. Apparently, it has never quite left my psyche. This set of moves will be unpleasantly like those – a massive, frantic rush at the beginning of summer and another set of the same, though one hopes not as frantic, at the beginning of fall.

Uncertainty. What happened to us is that our house was destroyed by a tornado a year ago. Since that time, we have been living in a house provided for us by the insurance company. Now, however, they’ve put us up here as long as they care to and our former house isn’t completely rebuilt and ready for re-occupancy yet. We’ve had just over a month to make alternative arrangements. Combine that with trying to get a three-month lease, and a one-bedroom was all we could find. (We call it “The Shack.”)

Belonging. I’ve had a hard time bonding with places where I’ve lived – they’ve never truly felt like home to me – and I hope that the rebuilt house, which we are completely furnishing, will have that feel of “mine.” But The Shack will feel the least like home since any I’ve lived in since college. Even my study, where I do my writing, will be a utility room with a table and chair rather than a desk. Nor will we have much in the way of furnishings. A bed, a television, two chairs, boxes for bedside tables, and not much else. The rest is in storage or not to be delivered until permanent move-in.

Immobilization. It is the one-year anniversary of the tornado and we will be swept up in a virtual tornado of packing and moving. I have already noticed tornado dreams and severe storm-related anxiety as the date approaches. I anticipate being virtually immobilized just when I need to be most productive and proactive. It already feels overwhelming.

Isolation. And no, there is no one around who can help us move. It’s just me and my husband, with maybe a little help from U-Haul and Two Men and a Truck. My husband suffers from depression, and between that and my bipolar disorder, we’ve been isolating so much that even with pizza and beer we couldn’t pull together a work gang.

We’ll get through, I know. And we’ll get through living in The Shack until it’s time to go home at last. I just wish I could see a clear path between now and then.

Like this:

While never leaving the category of persons with a serious mental illness, I seem to have also become a person with an autoimmune condition. Here’s what happened.

About two months ago, I noticed a hard lump growing on my forehead and another developing underneath my eye. Then one night, I rolled over in bed to feel a strange sensation in my right forearm – an area of thickened, hardening flesh under the skin about the size and shape of a cuttlefish bone. This seemed sudden and alarming compared to the forehead lump, so off I went to the emergency room. They diagnosed cellulitis and gave me a scrip for antibiotics.

A follow-up visit to my PCP revealed no change in my arm, but again a provisional diagnosis of cellulitis and another course of antibiotics.

When that failed to clear matters up, the doctor decided to biopsy the lump on my forehead and send me for an ultrasound and MRI on the arm. The biopsy revealed the lump to be a sarcoid, which immediately changed the thinking about my arm and cellulitis. It now seemed likely that that was sarcoidosis too.

Sarcoidosis is, according to the Mayo Clinic, “a disease characterized by the growth of tiny collections of inflammatory cells (granulomas) in any part of your body — most commonly the lungs and lymph nodes. But it can also affect the eyes, skin, heart and other organs.” I’m lucky that in my case, only the skin appears to be affected. Having my lungs affected would be pretty scary right about now. (The Mayo Clinic adds, “The cause of sarcoidosis is unknown, but experts think it results from the body’s immune system responding to an unknown substance.”)

Then the real fun began. The treatment my doctor prescribed was steroids (cream for the forehead, pills for the arm), which makes sense, but didn’t play well with my bipolar condition or meds. “Mood changes” appears on the Mayo Clinic’s list of potential side effects, along with agitation, irritability, and a host of other physical and psychological difficulties.

After a few days on the steroids, I began experiencing chills, raging headaches, insomnia, and the dry heaves. A tele-consultation with my doctor later and my dosage was reduced, which seems to have helped (and the steroids seem to be helping reduce my mysterious cuttlefish).

A mutually agreeable course of action was decided on. I would lay off the steroids for a day, then resume with a lower dose. That’s just what I have done, and my symptoms are better. At least I’m no longer retching.

What does the future hold for me? It’s hard to tell. Potentially steroid injections in my arm, and having the lump on my forehead removed if the steroids don’t resolve them. Potentially mood swings that I won’t know whether to attribute to my bipolar condition or to the steroids.

I hate the thought that this is an autoimmune disorder – that my body is attacking itself. Of course, my brain has been attacking me for so long, I really ought to be used to it by now.

Like this:

Of course, blogging didn’t exist when I started writing. It was quite a journey ending up where I am today. Even mental health services were a big blank to me when I was young, something that no one I knew experienced or even talked about, except to make jokes about going to “Wayne Avenue,” the location of the nearest insane asylum (as we called it then).

But it’s hard to remember a time when I didn’t write. Childish poems fueled by voracious reading. Hideously depressive poems fueled by burgeoning bipolar disorder. (I still commit poetry from time to time, writing sonnets and villanelles about bipolar disorder.)

But before I returned to poetry with more structure, I indulged in free verse – unrhymed, unmetered verse that relied on the juxtaposition of images rather than formal style. I studied creative writing in high school and college. But the bipolar disorder was undeniably with me, influencing the topics I wrote about: “Two Ways of Looking at the Same Pain” and “Whiskey on the Knife,” a poem about self-harm, are two examples.

As my poetry developed, it started reading more and more like prose, strung out in sentences that relied on line breaks with twists and jarring pauses to create poetic effects. Eventually, I gave up on poetry and simply gave in to prose. I made my living doing prose, and nonfiction at that, writing for magazines about education, technology, child care, and even martial arts.

Bipolar disorder took that away from me. After being diagnosed with clinical depression for years, I finally was identified as having bipolar 2. It was treatment-resistant for many years and during that time I was often unable to write.

My mental health blog, which you’re reading now, grew out of a journaling exercise. I began by listing what I did each day – not much, as I was stuck in a major depressive episode and not able to do much. But once again, what started as something else turned into prose. And by that time blogging was a thing.

I started blogging largely as an exercise for myself, to explore bipolar disorder, its symptoms and treatments, and my particular version of it. I set myself the task of posting once a week, a schedule that I still keep. I wrote short essays and longer pieces, whatever I was thinking about at the time. Hardly anyone read the blog. I sometimes wonder if the title “Bipolar Me” was a turn-off, but really that summed up my knowledge about bipolar – my own experiences.

Slowly, I started finding my voice. and finding things to say with it. Things other than what was inside my own head. Oh, I still wrote about my symptoms and my meds and my coping mechanisms, major depression and hypomania, mood swings and roller coasters. But I also started approaching the wider world of bipolar. Bipolar in the news. Bad science reporting about bipolar. TV commercials about bipolar meds. Bipolar disorder and gun violence. All of this was still through the lens of my own experience, as I have no degree in psychology, counseling, or biochemistry, for that matter.

And I started reaching a wider audience. My writing appeared in The Mighty, Invisible Illness, IBPF, Thought Catalog, Medium, and as guest posts on other bloggers’ sites. Eventually, I had enough material to make Bipolar Me into a book of the same name. And then a sequel, Bipolar Us. Both are still available on Amazon and through other outlets.

I know I’m not in the same league with mental health bloggers like Pete Earley and Gabe Howard. They are true activists and influencers, as well as terrific writers. Their work reaches thousands of people with information, analysis, inspiration, and more impact than I will likely ever have.

But I won’t give up blogging just because I’m not the best. I’ll be here every Sunday, posting my bipolar thoughts and opinions, sharing my bipolar experience, and chronicling my bipolar life.

Sometimes we need advice. But sometimes we just need to vent. This is true of all people but especially true of people with mental illness.

Venting is the act of getting something off your chest. It may come explosively if it has built up for a while. There may be one final incident, however tiny, that sets you off. All you really want is to feel heard, that someone acknowledges your distress and understands it. All you really need is a sympathetic ear and maybe a pat on the shoulder.

Venting acts as a safety valve. It allows you to “let off steam” that might otherwise build up pressure until it comes out violently, or at least excessively.

Why do I say this is particularly true of people with mental illness? So often we have feelings we can’t articulate, thoughts we don’t understand, or events that trigger us in both large and small ways. It’s natural to want to keep all these things inside. We’re taught to do that – not to “let the crazy show,” to keep all those messy thoughts and feelings to ourselves. Eventually, we get to the point where we think that no one will understand anyway, so there’s no point in giving voice to these feelings.

If I’m venting, the wrong thing to do is to give me advice. Unless I specifically ask for advice, that is. But even well-meaning advice can easily go wrong. People who do not suffer from psychiatric conditions often offer advice regarding what works for them when they feel a certain way. And yes, a walk in the fresh air and sunshine can certainly be uplifting. But when I’m too depressed to get out of bed, it can be an impossibility. It can even make me feel worse about myself.

To me, suggestions for possible remedies for my disorder are even worse. It’s taken me and my assorted doctors years to assemble the right medications at the right dosages to tame my bipolar disorder down to something livable. When someone tries to tout the latest remedy they heard about – Pilates, elderberries, juice cleanse, probiotics, or whatever – it feels to me like “pill-shaming,” like I’m being blamed because none of my meds will “fix” me thoroughly enough. Add the fact that these suggestions come from questionable sources – laypersons or bogus “studies” – and I’m likely to dig in my heels and feel offended.

At times, though, I do need advice. When I do, I usually get it from my therapist, someone else who shares my disorder, or an old friend who has been there for me on my journey. Sometimes I need a reality check – am I just catastrophizing or is it really true that something bad might be happening? Sometimes I need help dealing with a specific person – what can I say to my sister to help her understand my condition? Sometimes I need a reminder that I really ought to make an appointment with my therapist and get a “check-up from the neck up.”

And it should be understood that advice is just that – a suggestion that I am free to take or leave. Even my therapist, who usually gives very good advice when I ask her, sometimes suggests techniques or approaches that just don’t work for me. And even she knows that sometimes I just need to vent, to feel the feelings of sorrow or hurt or rage and let them out in a safe place. To quote Jimmy Buffet, “It cleans me out and then I can go on.”

Bipolar disorder is not just mood swings. Not everyone has moods that can last for months or years at a time or moods that are so extreme that they interfere with one’s daily life. The depths of despair and the rocketing highs are not what most people experience – and they should be glad they don’t. Bipolar disorder is a serious mental illness (SMI). It can be more or less severe, and it can be well or poorly controlled with medication and therapy, but the reality is that bipolar is a mood disorder, an illness, and a curse.

Of course, the mood swings of bipolar disorder don’t always last for months or years. Sometimes you go spinning out of control every few weeks. This is called “rapid cycling.”

But even rapid cycling doesn’t describe the lightning-quick mood changes that can happen within a day or two. That’s called “ultra-rapid cycling,” and it’s like being whip-sawed by your brain. Those valleys and peaks come so closely together that you don’t even have time to catch your breath between them.

I think that the official criteria miss the mark on this. Many of them define rapid cycling as experiencing four mood swings within a year. Ultra-rapid cycling seems not to have a specific definition, but I and a lot of other people with bipolar disorder experience moods that swing not over the course of months, but over the course of weeks, or even days.

Ultra-rapid cycling blurs the lines into mixed episodes. Those are occasions when high and low moods occur at the same time. For many bipolar sufferers, this means simultaneous exaltation and despair, which is a terrible combination and a bitch to experience. For me, a person with bipolar type 2 whose hypomania expresses most of the time as anxiety, a mixed episode is a frightening blur of defeat and nervousness, a simultaneous feeling that the worst has already come and that it is about to descend to even lower levels. It’s like ricocheting off the insides of your own skull.

What to do at a time like this is a puzzle. Do I try the things that soothe me when anxiety strikes? Do I try self-care for depressed moods? Do the two strategies cancel each other out, leaving me swinging helplessly? Do I try to suppress both moods, knowing that the consequent numbness will make it all the more difficult for me to feel “normal” moods again? Once those walls are built, they are hard to tear down.

Ultra-rapid cycling and mixed episodes may be handy jargon to describe mood swings that don’t fit the common mode of bipolar disorder. But they’re hell to live through. And since mood levelers, antidepressants, and anti-anxiety meds generally take a while to build up in the bloodstream enough to have an effect, there is little in the way of pharmaceutical help. An anti-anxiety pill may relieve the jitters and racing thoughts, but may also leave you more susceptible to the inevitable lows.

I don’t know if there’s much research going on regarding rapid cycling and mixed episodes. It seems like they’ve barely been named, much less defined or studied. And it’s true that there is a lot about plain old garden-variety bipolar disorder that remains to be understood and treated.

But for those of us who don’t fit the mold of months-long or years-long mood states, rapid cycling can be an uncomfortable way of life. When I was undiagnosed and unmedicated, I experienced those long, interminable lows. They did last months, years, until the depths of hell were all that I could see. The jags of ambition seldom visited me, but the creeping, lingering anxiety could easily take over. Now that I’m no longer subject to those excruciating extremes, I still am subject to the quick-change, rapid-fire series of moods. My mood levelers do work, in the sense that they reduce the peaks and valleys, but they never seem to put me on a totally even keel.

Perhaps that’s too much to expect. I’ll have to admit that I prefer a life of rapid- or ultra-rapid-cycling bipolar to the monotonous despair of long depressive cycles. At least now I have a firm conviction that the moods will end, or at least shift, to something more tolerable, and that that will happen sooner rather than later.

Given the choice between the lingering depths and the more rapid changes, I’ll take the one that doesn’t leave me in misery for years at a time.

Like this:

Alone time is a precious thing. But right now, with the self-isolation that accompanies the pandemic, many of us are experiencing too much “alone time.” But many of us need more.

Alone time has been important to me as I have struggled with bipolar disorder. I have a loving, supportive husband who is there when I need him to be. But even he knows that sometimes what I need is to be left alone.

Sometimes the world is too much with us, and we long to escape – read a book, hide under the blankets, just sit in the corner and think. At times like that, interacting with another person can feel like an intrusion, an annoyance, unwelcome. Alone time can allow you to catch your breath, calm yourself, practice mindfulness, or simply be alone with your feelings.

Of course, getting alone time is not always easy, especially now when we may be cooped up with our nearest and dearest, with no respite in sight. In my opinion, these are the times when a bit of alone time is even more necessary. Even with people you love, being with them 24 hours a day, every day, will begin to wear on you all. Stress builds and you may be triggered by noise, conflict, or other stimuli.

I’m lucky. That supportive husband knows, if his other efforts at drawing me out (offering me food, or a movie, or music) have failed, the greatest gift he can give me is alone time. He’ll even ask me if I need alone time, in case I don’t realize that is exactly what I do need.

I’m also lucky that there is a dedicated space in my house that is perfect for alone time – my study. It has a computer, music, comfort objects, games, favorite pictures, and more. It even has a comfy chair so that I can just sit and think if that is what I need to do. I know that I come at this topic from a place of privilege.

Making mental and physical space for alone time is harder when you have a roommate or a family that doesn’t understand the concept of alone time. The TV may be blaring, the washer clanking, the kids yelling, the spouse being needy. There may be someone in every room of the house, making noise or demanding your attention. Sometimes you can’t even be alone in the bathroom. You want everything to stop, just for a while.

In situations like that, you may have to ask for alone time. First, realize that it’s a reasonable request. Suggest ways to make it happen – I need to be alone in the basement (garage, kitchen, yard, whatever) for a while. Don’t disturb me unless someone’s bleeding or something’s on fire. Offer to return the favor. If you’re feeling pent up, chances are someone else in the house is too.

Of course, too much of a good thing is not necessarily a good thing. Even though I need a fair amount of alone time, too much can leave me stuck inside my own head, not always a comfortable place to be. I can brood, catastrophize, feel lonely or bored, give in to depression. It helps if I can recognize when alone time is turning toxic like that. When I’ve had enough alone time, I can choose to leave that behind and rejoin the world in a better frame of mind.

As far as I can see, alone time is vital for every person, even the very gregarious. It allows us to let go and drop our metaphoric masks. But alone time is particularly necessary for those with mental illness. The ability to be alone with oneself can be a powerful step in understanding and healing. And whether time alone is the norm or the exception now, people’s mental health suffers. Connection is what we hear most about – virtual meetings, video chats, texts, and calls – but alone time is vital too. Treasure it when you get some.